Seeing the victim prior to impact

Some people reported seeing the face or the eyes of the victims in the seconds before the incident occurred.

Risk

Protection

The seven (out of 40) participants who mentioned seeing the face or eyes of the victim prior to impact felt profound helplessness and horror.

They reported being haunted by the memory of what they saw up to several years after the incident. This occurred with both suicides and accidents. Those who saw the eyes of the victim experienced longer term and more intense symptoms.

Type of incident

Accidents and suicides were compared. Participants were asked to reflect upon the difference it made to be involved in a suicide versus an accident. Whatever the type of incident, the initial reactions are of shock and pain. However, after these initial, almost physical reactions, crew members developed different attitudes, sometimes quite contradictory.

Type of incident

Risk

Protection

Accident

Accidents are more often perceived as avoidable, therefore, increased feelings of loss and helplessness

Involvement of a young person makes it more traumatic

Suicide

More short term reactions (particularly more anger)

Increased risk of PTSD

Being aware of the intent of the person lessens the sense of responsibility of the employee.

Sometimes it is easier to make sense of the incident, lessening its emotional impact, but increasing anger

Dealing with the victim(s)

After a collision occurred, the conductor must check on potential victims, provide first aid help if necessary and guide first responders to the scene. During these actions, they have to see, touch and interact with injured or fatally wounded people, while they are themselves in a state of shock.

Risk

Protection

People experience increased short term stress reactions and feelings of helplessness when they cannot help the victim.

Some people indicate that having to walk back along the train, wondering what they will find is a very stressful situation and that it was one of the most difficult things to have to do during the incident. Feeling forced to do this and to deal with the body had significant long-term consequences.

Perceiving the helplessness of the victim

In the context of railway CI, vulnerable victims are young, elderly or disabled people, car passengers, people who could not be aware of the danger or get out of the way, people whose distress crew members could relate to. This helplessness increases the perception of victim’s vulnerability.

Risk

Protection

Feelings of empathy towards the victim may increase traumatic reaction

Interactions with police

Local police officers are usually the first on the scene after a fatality. They are often the first people the crew sees after the initial shock of the accident. They therefore play an important part in the way the crew deals with the event. We have to be very careful not to generalize about interventions by the police at the time of the incident and their impact on crew members. The incidents described are spread over a 35-year time frame and police protocols have changed during that time. Things have improved over time, to the benefit of train crews.

Risk

Protection

Tactless or clumsy handling by police officers induces frustration and anger. These are the elements that tend to stick in their minds and provoke rumination.

Lack of knowledge of the trade, asking for inappropriate information or making insensitive comments are the most frequent forms of mishandling by police on site.

Since protocols have been developed, the lack of knowledge of and compliance with protocols are the main sources of frustration

Being treated as suspects by the police increases trauma (Abott 2003 )

Some police intervention can reduce tension and stress levels.

Treat crew as victims of the incident

Enquire on the wellbeing of the crew

Show empathy and care

Delay questioning about the incident when possible

Provide crew members with minimal information to help them understand why things happened

Implementation of the Critical Incident Response Programme: Interactions with local managers

This interaction occurs at different levels:

Interpersonal contact

Implementation of the Critical Incident Response Programme

Follow-up

The local manager is the representative of the company and embodies the company’s attitude and expectations towards the crew members during and after the critical incident. At this particularly sensitive time all interactions are important and can have profound long term effects.

Risk

Protection

Immediate download of the black box puts the emphasis on identifying responsibilities rather than taking care of the crew.

A request to drive the train puts the crew in a situation where they can make mistakes and where their shock is not recognised by their employer.

Uncertainties and challenges in incident management can have negative impacts on crew members. Their cognitive functioning and emotional state are not optimal because of the shock they went through. They might react emotionally to events that may not appear difficult to an outsider. These events will stick in their mind and fuel anger and resentment toward the company and those involved, lengthening the post-event distress and trauma.

Elements of incident management putting crews at risk include:

Absence of a supervisor on site

No expression of care by the supervisor

Being questioned with suspicion

Being left to wait for a long time to be relieved

Being instructed to move the train or to help with the body

Having to stay close to the body

Having to drive home after the incident

Lack of caring follow-ups

Unmet expectations of support and care

Empathy

Immediate relief of the crew

Not pressurising the conductor to walk back to the scene if they do not feel fit to do so

Ongoing compassionate contacts throughout the situation

Sticking to a specific and well known sequence of actions reduce uncertainty and brings back a sense of control, familiarity and reassurance that is crucial for faster recovery

Having someone from the company in charge of the situation and of the welfare of the crew shows that the employer cares about what happened and helps crew members deal more positively with their experience (seeking help, expressing needs, regaining trust in their work environment, feeling supported to come back to work)

A more detailed analysis shows that in 35 of the 103 accidents and suicides (34%), crew members clearly stated that they experienced inadequate support from their employer. Most of these crew members (24/35) displayed strong symptoms in the short-term and this group also include all of those with long term symptoms (7 PTSD).

Therefore, the mishandling of incidents appears to have long-term effects. People tended to generalise their perception of bad management to other aspects of their work and remember incidents longer when they had to deal with poor management. This, in turn, undermined their trust in their employer and made it more difficult for them to come back to work comfortably.